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In case you didn't have the opportunity to check out my interview from last week, here it is. Also, just to let you know, Patient Anonymous did turn on her RSS feed, so feel free to put her in your bloglines, google reader, or whatever...

After discovering political Web-logs a few years ago and medical blogs this year, a young primary care doctor was tempted to start his own site: Doctor Anonymous. Despite his unfamiliarity with the medium, Dr. A's humor, attentiveness, and genuine rapport with his readers quickly earned him a large, faithful audience. I'd guess those same traits would make him a good physician, but I suppose we'll never know for sure...

Corresponding with Dr. A this week, I had the chance to learn a little bit more about the man and what he thinks about his online endeavors.

Dr. Genes: Many blogs come and go, but few start off with -- and maintain -- the exuberant enthusiasm of yours. Is this your first foray onto the Web and having an online presence? Are you like your posts would suggest, or are you more reserved and bookish in person?

Dr. A: Probably like most other people, at first I was intimidated by starting my own blog. There are so many great blogs out there that I really didn't know what else I could contribute or what I could do to set myself apart. It was a good 5 or 6 months of me going back and forth on whether to become a blog writer and not just a blog reader. My first blog was in May (not many people out there know that), but it did not work out at all. I was using my real name at the time. I live in a small Midwestern town in the United States, and I didn't realize that people on the Internet can learn all kinds of information about you. I then became very paranoid about what I was writing, and the blog was just boring. So I scrapped that idea and didn't know if blogging was still for me.

The Doctor Anonymous blog launched on June 19, 2006, with a mere 5-line post. Being anonymous really has let me be free to not worry as much about what I'm going to type. Being a doc in a small town is tricky; I'm constantly worried that anything I say or do may end up in our local newspaper, so I'm constantly filtering what I'm going to say. With blogging, I feel a sense of freedom of expression that I haven't felt in a long time.

People ask me what I'm like in person. I guess that's hard for me to describe. I certainly didn't make up this phrase, but I would describe myself as an "extroverted introvert." For the most part, I'm a pretty laid-back guy, but sometimes when I get around people, I'm a lot more outgoing. I guess that's what happened when I started my blog.

I absolutely had zero experience at producing any kind of Internet content. I have a lot of experience at being an Internet consumer, but not a producer. So those first 2 weeks of blogging, I had no idea what I was doing. The one thing that really fascinated me was the interaction with people in the blogosphere. I talked about my first contact with other bloggers.

Dr. Genes: What are some of your favorite posts? Something that really resonated with readers, or captured something you worked hard to express?

Dr. A: One post that sticks out in my mind is called "Why". I wrote it during a bad night on call. It was definitely a change in the upbeat style I was doing for the previous 4 weeks. I hesitated on posting it, because I didn't quite know what kind of response I would get. But I did anyway, because I wanted my blog to be a reflection of me, and sometimes you have bad days. I was quite surprised by the response I got. For the next couple of days, my frequent readers did a type of reflective post of their own. And I really learned that people outside the United States were reading my blog. To think that my little blog is reaching people around the world blew my mind.

Dr. Genes: Some of your posts point to a soul-searching about what your blog should do for you, where it should go. Has writing frequently become too much of a chore? Will you be going more or less medical? What have you gotten from this community of readers and fellow bloggers?

Dr. A: I try to have a mix of medical and nonmedical topics. In my first posts, I had a lot of blogging questions. So I just put questions out there like, What does it mean to be tagged? Or, Do I have to respond to all the comments in my comment section? Or, What is Grand Rounds? Sometimes, I would ask questions I was just curious about, like, Do you prefer your doctor to wear a lab coat or not? I have very much appreciated the interaction that I've gotten from my readers.

There were times when I talked about blogging feeling like a chore. I have told myself that when I feel like blogging is like work, then that's the time for me to take a blog break, or even consider giving it up altogether. People have even told me that they sense that my energy level is not like it was that first month. But I guess that's normal, right? Whenever you first start a project you really like, there is a natural excitement. But as time goes on, that honeymoon period dissipates, and you ask yourself whether you want to keep blogging.

Even though it's only been 5 months since I've been doing this, I feel a significant change in my blog coming in the near future. My early posts talked a lot about patient encounters, and now I feel like I've shifted a little bit more toward news commentary. What the next change will be, I don't know.

I feel very lucky to have achieved what I have up to this point. And that's the advice I have for anyone considering blogging. Here's what I wrote on June 21, Day 3 of blogging, and I think it still holds true: "Blogging is like being at the podium, and to get people to listen to you, your thoughts have to be pretty well developed, or people will walk away. The good blogs that I've run into make me think a little bit and make me post a comment. The interaction with people (conversation like interactions) takes place in the comment area. The blog is kind of like the lecture and the comments are like the Q&A."

Dr. Genes: The shadowy but genial figure of Dr. Anonymous steps into the spotlight this week to host Grand Rounds, the collection of the best in online medical writing. Check out Dr. A's edition of Grand Rounds on November 21, 2006.